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2010 Medicare Advantage Plan Information Click here to jump to the Chart Legend & Search Tips | |||||||||||
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Plan Name | County | Monthly Prem. (Parts C & D) |
Deduct- ible |
(Donut Hole) Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance 30-Day Supply |
Members In This Plan ID | |||||
Cust. Service Rating |
Member Plan Exper. |
RxCost Info Rating |
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AARP MedicareComplete Choice Plan 1 (PPO) - H1717-001-0 Benefit Details |
Sedgwick | $0.00 | $0 | No Gap Coverage | Tier 1 Preferred Generic Brand: $5.00 Tier 2 Generic Preferred Brand: $42.00 Tier 3 Non-Preferred Generic Non-Preferred Brand: $79.00 Tier 4 Specialty: 33% | 917 members Browse Formulary | |||||
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Advantra Advantage (HMO) - H2672-003-0 Benefit Details |
Sedgwick | $0.00 | $0 | No Gap Coverage | PREFERRED GENERIC: $7.00 PREFERRED BRAND: $35.00 NON-PREFERRED GENERIC/NON-PREFERRED BRAND: $60.00 SPECIALTY- GENERIC AND BRAND: 33% | 75 members Browse Formulary | |||||
Advantra Freedom (PPO) - H5509-003-0 Benefit Details |
Sedgwick | $0.00 | $0 | No Gap Coverage | PREFERRED GENERIC: $6.00 PREFERRED BRAND: $35.00 NON-PREFERRED GENERIC/NON-PREFERRED BRAND: $60.00 SPECIALTY- GENERIC AND BRAND: 33% | 3,528 members Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-069 (Regional PPO) - R5826-069-0 Benefit Details |
Sedgwick | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a | ||||||
HumanaChoice R5826-069 (Regional PPO) - R5826-069-0 Benefit Details |
Statewide | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a | ||||||
SecureHorizons MedicareDirect Plan 3 (PFFS) - H5435-003-0 Benefit Details |
Sedgwick | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 24,942 members | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
Evercare Plan DP (PPO) - H1717-006-0 Benefit Details |
Sedgwick | $ for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | 154 members Browse Formulary | |||||
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Today's Options Value (PFFS) - H5421-055-0 Benefit Details |
Sedgwick | $30.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 5,383 members | ||||||
Humana Gold Choice H2944-012 (PFFS) - H2944-012-0 Benefit Details |
Sedgwick | $46.00 | $0 | Few Generics, Few Brand | Preferred Generic: $8.00 Non-Preferred Generic/Preferred Brand: $40.00 Non-Preferred Brand: $80.00 Specialty: 33% | 4,865 members Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice H1716-002 (PPO) - H1716-002-0 Benefit Details |
Sedgwick | $50.00 | $0 | Few Generics, Few Brand | Preferred Generic: $5.00 Non-Preferred Generic/Preferred Brand: $40.00 Non-Preferred Brand: $80.00 Specialty: 33% | 888 members Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) - H5421-073-0 Benefit Details |
Sedgwick | $51.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 10,805 members Browse Formulary | |||||
SecurityChoice Classic (PFFS) - H0540-088-0 Benefit Details |
Sedgwick | $55.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
SecurityChoice Plus (PFFS) - H0540-089-0 Benefit Details |
Sedgwick | $56.00 | $0 | Many Generics | Tier 1 Preferred Generic Drugs: $8.00 Tier 2 Preferred Brand Certain Generic Drugs: $44.00 Tier 3 Non-Preferred Brand Certain Generic Drugs: $85.00 Tier 4 Non-Specialty Injectable Drugs: 33% Tier 5 Specialty Drugs: 33% | n/a Browse Formulary | |||||
Today's Options Premier (PFFS) - H5421-049-0 Benefit Details |
Sedgwick | $69.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 8,597 members | ||||||
Sterling Basic Plus (PFFS) - H5006-018-3 Benefit Details |
Sedgwick | $109.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 10,911 members | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
Today's Options Premier powered by CCRx (PFFS) - H5421-067-0 Benefit Details |
Sedgwick | $112.00 | $0 | All Generics | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 4,339 members Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) - R5826-013-0 Benefit Details |
Sedgwick | $142.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | 474 members Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) - R5826-013-0 Benefit Details |
Statewide | $142.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | 474 members Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
Sterling Option II (PFFS) - H5006-017-3 Benefit Details |
Sedgwick | $170.00 | $225 | No Gap Coverage | Generic: $10.00 Brand: $34.00 Specialty: 25% | 8,639 members Browse Formulary | |||||
Sterling Option I (PFFS) - H5006-014-3 Benefit Details |
Sedgwick | $183.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 43,891 members | ||||||
Sterling Option IV (PFFS) - H5006-016-3 Benefit Details |
Sedgwick | $196.00 | $225 | No Gap Coverage | Generic: $10.00 Brand: $36.00 Specialty: 25% | 3,337 members Browse Formulary | |||||
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